The degree and characteristic of airway inflammation were evaluated by the proportions of bronchoalveolar lavage (BAL) cells. Clinical asthma types such as Ia. simple bronchoconstriction, Ib. bronchoconstriction + hypersecretion, and Ⅱ. bronchiolar obstruction correlate with airway inflammation. The increased proportion BAL neutrophils is characteristic of type Ⅱ asthma, and increase in BAL eosinophil count is often observed in type Ib asthma. Bronchial hyperresponsiveness also correlates
with airway inflammation. Action of spa therapy has been speculated to be related to airway inflammation, since the therapy has no action inhibiting IgE-mediated allergic reaction. In fact, spa therapy is more effective in patients with type Ib and type Ⅱ than in those with type Ia showing slight degree of airway inflammation. Bronchial hyperresponsiveness is also improved by spa therapy. From a point of view, the direct action of spa therapy may be to clean airways and improve damaged mucous membrane of the airways, leading to suppression of airway inflammation.